Past Issue

Volume 13, Number 2, Jul-Sep 2019 Pages: 93-96

Comparison of First Trimester Screening for Down’s Syndrome Using Free Beta-Human Chorionic Gonadotropin and Pregnancy-Associated Plasma Protein-A Levels between Spontaneous and IVF Pregnancies at 12 Weeks of Gestation

Robabeh Taheripanah, M.D, 1, Maryam Talayeh, M.D, 2, Marzieh Zamaniyan, M.D, 3, 4, *, Donya Khosravi, M.D, 2, Anahita Taheripanah, B.Sc, 5,
Infertility and Reproductive Health Research Center (IRHRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran
Imam Hossein Hospital, Obstetrics and Gynecology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
Infertility Center, Department of Obstetrics and Gynecology, Mazandaran University of Medical Sciences, Sari, Iran
Department of Molecular and Cellular Sciences, Faculty of Advanced Sciences and Technology Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
*Corresponding Address: Diabetes Research Center Mazandaran University of Medical Sciences Sari Iran



In some previous studies, it was shown that first trimester screening tests produce equivocal results in in vitro fertilization (IVF) pregnancies. The purpose of this study was to compare free beta-human chorionic gonadotro- pin (β-hCG) and pregnancy-associated plasma protein-A (PAPPA) levels between single normal and IVF pregnancies during 11 to 13 week (+ 6 day) of gestational age.

Materials and Methods

In this observational cohort study, 300 consecutive single IVF pregnancies and 700 single normal pregnancies were enrolled at about 11-13 week + 6 day gestational age and levels of free β-hCG and PAPPA were compared between the groups.


The results demonstrated that PAPPA (P=0.026) was significantly lower and β-hCG (P=0.030) was signifi- cantly higher in IVF pregnancies. The other factors including nuchal translucency (NT) and crown-rump length (CRL) and demographic characteristics did not significantly differ between the groups (P>0.05).


This study showed that PAPPA levels are lower but free β-hCG levels are higher in single IVF versus normal pregnancies. This finding could be related to different placentation in intracytoplasmic sperm injection (ICSI) technique because of alterations in oocyte cytoplasm. Therefore, these markers may need to be adjusted in assisted re- productive technology (ART) conceptions. Further research should be done to obtain optimal cut-off for these markers in first trimester screening for detection of Down syndrome in ART pregnancies.